Individual
CONNE R TIPPETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
639 W COULTER AVE, POWELL, WY 82435-2527
(307) 754-9262
(307) 754-9283
Mailing address
639 W COULTER AVE, POWELL, WY 82435-2527
(307) 754-9262
(307) 754-9283
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR-155
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192550
WORK COMP
WA
01
—
310810
BLUE CROSS BLUE SHIELD
WY
Enumeration date
09/29/2006
Last updated
07/08/2007
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